The Wee Dude Alfie earned his wings 23rd June, 2015

[Patty]

Re: Diggydog

Good for you Allison!

[diggydog]

Re: Diggydog

Alfie had his weekly weight check yesterday and is now 6.85kg
Thats a 350g increase in weight this week and over all 1kg in 2weeks!!!
The increase is slowing down which is good as he doesn't have too much more to go until he hits his target.
He bones dont look like they are about it burst through his skin and even tho he is still on the thin side he has lost the starved look he had and is looking sooooo much better. Much nicer to cuddle now his bones dont dig into me quite so much.

Progress. Woo hoo

[Tikobird]

Re: Diggydog

Yea Alfie

[ozzi]

Re: Diggydog

That's wonderful news! It's nice to see Alfie plumping up...LOL!

And, KUDOS to you for getting out home testing information by responding to that dog magazine...I couldn't be prouder of you! It's really one of my pet peeves if you will, and I hope it will become more and more accepted, one diabetic dog owner at a time! I educated my vet who wasn't exactly "for it" in the beginning and now she thinks its a very valuable tool. I also had to bring Ozzi in for a hypo event, and the emergency vet was surprised that I home tested. She never had an owner do that, and she started asking me a ton of questions about it! I think it's important to get the word out whenever possible, and hopefully a cultural change will follow. Until I came here I had no idea that I could home test Ozzi, so it's important to let people know there is that option available. Let us know if the magazine publishes your response.
Kevin

[diggydog]

Re: Diggydog

Thanks Kevin!

In an ideal world my article will get published and ever diabetic pet owner in the uk will read it and start home testing but even if its only the person who receives the article who reads it then at least thats one more person that knows about home testing.

I dont know where we would be without it now and its hard to think we went 2years without it

I would never have been able to get anywhere with Alfie on Levemir if we didn't home test and its really has avoided a few potentially scary situations with him!

[diggydog]

Re: Diggydog

I have just done Alfie's first curve since starting Levemir. Its been 2weeks since he started it but the first wee while we had to sort out his dose so he didn't hypo and I also figured out his walk morning walk was pushing him too low so I had to move this from 10.30 to 7.15am.
Alfie gets food (90g) and insulin (1/2unit) at 8.30am & pm with food (30g) at 12pm.
He is normally walked at 7.15pm for an hour but I had stuff on tonight and walked him at 5.30pm for an hour. The results of this shocked me.

So if anyone had any ideas on how to sort his curve out a bit I am all ears

8.30am - 428
9.30am - 466
10.30am - 484
11.30am - 344
12.30pm - 292
1.30pm - 275
2.30pm - 218
3.30pm - 209
4.30pm - 272
5.30pm - 306
6.30pm - 122 (odd, but he had just been walked. Walks dont normally drop him this much at all)
7.30pm - 216
8.30pm - 302
9.30pm - 252 (again an odd result as he normally has a wee spike after his food)

all suggestions are very welcome!

Just checked him again just now at 10.30pm and he is 196 ???????????

[ozzi]

Re: Diggydog

I don't think the curve is particularly odd, and I think the bg drop from 306 to 122 between 5:30 and 6:30 is definitely related to the hour walk Alfie had. I know many of us, including me, have noticed drops with walking. Ozzi dropped about 50 points with just a 10 minute walk, and I know others have mentioned that their dogs drop over 100 points with a walk. I'm thinking that an hours walk is most likely responsible for the drop you see. The drop at 9:30 is more difficult to interpret. Was there any rough play, guests arriving, or something that got Alfie all jazzed up between 8:30 and 9:30 that may have caused a drop, just as exercise can?
Kevin

[diggydog]

Re: Diggydog

Hi kevin,

nothing between 8.30 and 9.30 other than him in his bed sleeping - checked him again a few mins ago at 10.30pm and he is down to 196?

[ozzi]

Re: Diggydog

That is odd then! I can't imagine why he is dropping that quickly. I noticed this morning between 10:30 and 11:30, he dropped 140 points, so given that he is 196 now, I would definitely check the 11:30 tonight to make sure the same thing doesn't happen that did this morning. I'm not familiar with Levemir, and can't offer any specific advice, but I would want to watch his 11:30 tonight since that time frame was the biggest drop this morning. Let us know. And I hope someone more familiar with Levemir can help. How many hours after injection is it "supposed" to peak?
Kevin

[diggydog]

Re: Diggydog

Levemir is a basal human insulin and so I meant to act as a long acting "background" human insulin with NO peak. True to form Alfie has other ideas about it. The whole curve is just very odd.
At 11.30pm he was 202 - nothing about the curve makes any sort of sense to me so cant even begin to imagine where or what can sort it out

I am wondering if its worth considering his morning higher bg's to be the result of rebound??
Maybe I am just grasping at straws for an answer, I just dont understand it at all ????

[ozzi]

Re: Diggydog

I don't understand it either, BUT, I'm glad to see the 202 at 11:30! I didn't realize that Levemir does not peak. I know nothing about how it works, but in light of what you have explained to me, I understand why you feel his curve is so strange. I wish I could be more helpful. Hopefully others will understand what's going on with the curve given that you are using Levemir.
Kevin

[diggydog]

Re: Diggydog

Thanks Kevin

That 202 is not looking so good now that its 12.30am and he is down to 130
I think it might be an idea to reduce Alfie to just 1 injection a day as its looking more likely that his morning reading is rebound but I feel like a long night of testing is ahead of us to try and figure it all out.
I know 130 is not a "low" reading but given I cant predict was going to happen during the night then maybe its a good idea to try and stay up to see exactly whats happening

[ozzi]

Re: Diggydog

I agree 100%. The 130 is fine, but the 72 point drop in one hour is a bit concerning. It will be interesting to see what the next test shows. Poor Alfie

[Cornspot]

Re: Diggydog

I probably would have done a restick for that 6:30 one. Also, all meters have an error percentage (it really is a percentage, not a certain number of points), so some of those drops that look big might not really be that big.

If I stick myself 3 times one right after the other, I will get three different readings.

I am very interested is following your progress using the Levemir!

The mornings could be rebound. Levemir is usually started in humans once per day. It seems to last pretty close to 24 hours in type IIs but less than 24 hours in type Is. I wonder if using two injections is causing an overlap or action?

[Patty]

Re: Diggydog

Allison,
I'm going to highlight your routine so I can see it clearly here.

Alfie gets food (90g) and insulin (1/2unit) at 8.30am & pm with food (30g) at 12pm.
He is normally walked at 7.15pm for an hour but I had stuff on tonight and walked him at 5.30pm for an hour. The results of this shocked me.

So if anyone had any ideas on how to sort his curve out a bit I am all ears

8.30am - 428 - So 90g food and 1/2 u insulin here
9.30am - 466
10.30am - 484
11.30am - 344 - dropped 140 points
12.00pm - 30g food
12.30pm - 292
1.30pm - 275
2.30pm - 218
3.30pm - 209
4.30pm - 272
5.30pm - 306 1 hour walk (not usual time)
6.30pm - 122 (odd, but he had just been walked. Walks dont normally drop him this much at all)
7.30pm - 216 (7:15pm usual walk time)
8.30pm - 302 90g food and 1/2u insulin
9.30pm - 252 (again an odd result as he normally has a wee spike after his food)
10.30pm - 196
11.30pm - 202

Obviously every dog responds a bit different and one basal insulin is not the same as another, but just to try to shed some light on things based on my limited experience with Ali on Lantus...

We ran into overlap. Lantus lasted about 15 hours if I remember right in Ali so balancing the overlap was a bit tricky. Second, in order for the insulin to match the food, the dose had to be high enough to prevent a large food spike but when the food was gone, the insulin was still just as strong and too much for the body.

I also wonder what's happening overnight if you don't also have a 12am feeding. Rebound could be a possibility. It could also be the lack of activity that causes a big rise.

A lot of possibilities. I remember Ali got a "peak" on Lantus around hour 10 or so. I tried dividing up her feedings into equal parts at equal intervals throughout the day/night but I really got no sleep at all.

Another possibility is the the Levemir is not lasting the full 12 hours. Grace's Rolo only got about 10 hours duration out of Levemir. So the climbing numbers could be the insulin running out early.

I wonder if Alfie typically rises at the end of his curve without the big drop from the walk. It doesn't look like overlap by the time 8:30pm rolls around but that could've been due to a glucose dump by the liver from the fast drop between 5:30-6:30pm.

I know I haven't helped solve anything but hopefully it's food for thought as you try to sort things out.

Patty